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The Relationship Between Duration of Physical Therapy Services in the Acute Care Setting and Change in Functional Status in Patients With Lower-Extremity Orthopedic Problems

KE Roach, PhD, PT, is Assistant Professor, Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, 5915 Ponce de Leon Blvd, Coral Gables, FL 33146 (USA) (kroach@mednet.med.miaini.edu).
D Ally, PT, is Staff Therapist, Parkway Regional Medical Center, North Miami, Fla. She was a graduate student in the Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, at the time this study was conducted.
B Finnerty, PT, was a graduate student in the Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, at the time this study was conducted.
D Watkins, PT, is Staff Therapist, Outpatient Service, Miami Veterans Affairs Hospital, Miami, Fla. He was a graduate student in the Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, at the time this study was conducted.
BA Litwin, PT, is Health Care Consultant, Polaris Group, Plantation, Fla. She was Director, Rehabilitation Services, Parkway Regional Medical Center, at the time this study was conducted.
B Janz-Hoover, PT, was Senior Therapist and Center Coordinator of Clinical Education, Parkway Regional Medical Center, at the time this study was conducted.
T Watson, PT, is Senior Therapist, Acute Care Service, Parkway Regional Medical Center.
KA Curtis, PhD, PT, is Associate Professor, Physical Therapy Department, California State University, Fresno, Calif.

Background and Purpose. This study examined the relationship between the duration of physical therapy and functional status at discharge. Subjects. The subjects were 173 inpatients, with a mean age of 67.9 years (SD=20.5, range=18–101), referred to physical therapy with lower-extremity orthopedic problems. Methods. For this retrospective cohort study, medical and physical therapy quality assurance records were used. Functional status, at initiation of and discharge from physical therapy, was measured using the Acute Care Index of Function (ACIF). The ACIF scores, which ranged from 0 to 100, were obtained from quality assurance records. The duration of physical therapy was the number of minutes of physical therapy billed to each patient, as determined from billing records. Results. Subjects received an average of 238.5 minutes of physical therapy (SD=153.6, range=15–1,110). Function improved an average of 15.4 points (SD=17.0, range=–27.4 to 64.9), and the duration of physical therapy was an important predictor of functional status at discharge after controlling for age, length of hospitalization, number of diagnoses, and initial functional status. Conclusion and Discussion. This study provides evidence that the amount of physical therapy that patients with some types of orthopedic problems receive is directly related to the functional improvement that occurs during hospitalization in an acute care setting.

Key Words: Functional status • Lower extremity, general • Orthopedics, general • Treatment outcomes

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